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New Scientist Live

Forum : This womb for hire?

By Ursula Mittwoch

London

Of all methods of assisted reproduction, surrogacy attracts the widest
opposition. When things go wrong, they hit the headlines, and then there are
calls to make the process illegal. To stem public disquiet in Britain, the
government has set up a committee to investigate all aspects of surrogacy,
including the question of payment.

A recent British surrogacy arrangement that came apart involved a Dutch
couple. All went well at first, but then the future surrogate mother fell out
with the proposed adoptive parents and an announcement appeared that she had
aborted the fetus. A few days later came a second announcement to the effect
that she had lied about the abortion, but had decided to keep the child.
Inevitably, the couple who had been looking forward to the baby were
heartbroken.

It is not obvious, though, why this case, and others like it, should be a
reason for any change in the law. Many marriages go wrong, and some even end in
murder, but this does not usually result in demands for marriage to be made
illegal.

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Another puzzling aspect of the surrogacy issue is the view held by the great
and the good that surrogate mothers should not receive payment for their
services, other than, at most, modest expenses. Payment, it is thought, would
detract from her generosity and altogether cast doubt on her reliability and
motives.

It is worth noting that no such restrictions are placed on the obstetrician
in the team, whose motives or reliability are not treated as suspect if he or
she receives a high income. But there seems to be a widely held opinion that a
woman agreeing to be a surrogate mother is expected to undergo nine months of
pregnancy, preceded by lengthy negotiations and physical interference, followed
by childbirth and handing over the baby—and all for pocket money.

If this were the law, and if surrogacy contracts cannot be enforced, there
could be a strong temptation for a woman to supplement her income, and she
hardly needs to be a financial whiz kid to realise that she can earn a lot more
money by selling her story to the media than by fulfilling the arrangement into
which she has entered

Surrogacy is often denounced as an exploitation of the surrogate mother, but
the idea that the exploitation is increased if she receives payment is surely
paradoxical. One likely reason for this view is that most surrogate mothers
belong to the “economically disadvantaged classes”, and it is arguably a case of
exploitation if a woman is driven to use her womb to escape from a state of
poverty. It is obvious, though, that surrogacy bears no responsibility for our
social system, and value judgments of exploitation by the commissioning parents
are misplaced.

There are, of course, no fail-safe strategies, but it would help to vet all
individuals concerned in surrogate arrangements to have properly drafted
contracts with a clause preventing either side from talking to the media.
Sensationalising such private affairs is bound to distort the truth and is not
in the public interest.

The issue of the surrogate mother has a historical parallel with the wet
nurse, who from antiquity until modern times played an important part in feeding
the infants of mothers who either could not, or would not, breast-feed their
own.

Valerie Fildes, in Breasts, Bottles and Babies, tells us that during
the 17th century Puritan theologians devoted sermons and large tracts of popular
conduct books to the evils of mothers who did not breast-feed. But the
disappearance of the wet nurse was due neither to preachers nor the law. It came
about through scientific discoveries about infant feeding during the 19th
century, followed by the commercial availability of baby milk formulas.

Gestation now seems to be the only part of human reproduction which cannot
yet be done in the laboratory. However, three-quarters of a century ago, the
British biologist J. B. S. Haldane foresaw the development of babies outside the
womb and named the process ectogenesis. In his fantasy of the future
Daedalus, or Science and the Future, published in 1923, he wrote: “It was
in 1951 that Dupont and Schwartz produced the first ectogenetic child…[They]
obtained a fresh ovary from a woman who was the victim of an aeroplane accident,
and kept it living in their medium for five years. They obtained several eggs
from it and fertilised them successfully, but the problem of nutrition and
support of the embryo was more difficult, and was only solved in the fourth
year.”

Aldous Huxley elaborated this idea in Brave New World, published in
1932, in which he gives a vivid description of the Central London Hatchery,
where eggs and sperm are stored in test tubes. After in vitro fertilisation, the
embryos undergo a series of scientific treatments until they have developed to a
stage equivalent to that at birth. Viviparity, at least for women, has become a
thing of the past.

Some scientific forecasts become reality, others do not. In the real world,
in vitro fertilisation has become an option, but the development of the fetus
remains basically an old-world phenomenon. The improvements in keeping premature
babies alive merely emphasise the difficulties posed by life outside the womb
even for fetuses that have pretty nearly completed their development. If
ectogenesis were feasible, surrogate mothers would no longer be necessary. In
reality, however, the womb will remain an essential organ for human reproduction
for the foreseeable future. It deserves a more rational approach than it is
presently accorded.

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Ursula Mittwoch is in the Department of Anatomy,
Queen Mary and Westfield College, London.